Technical work plan for the privatization waste characterization data quality objective process

This work plan addresses the activities necessary to complete the data quality objectives process for the purpose of providing sufficient characterization information to successfully stage, pretreat, and immobilize low-activity waste per the requirements and specifications identified in the Tank Waste Remediation System Privatization Request for Proposal. The scope of this task is to complete the data quality objectives process, the results of which will provide a technical basis for sampling and characterization needs related to privatization of pretreatment and low-activity waste immobilization

Social and spatial heterogeneity in psychosis proneness in a multilevel case-prodrome-control study

To test whether spatial and social neighbourhood patterning of people at ultra-high risk (UHR) of psychosis differs from first-episode psychosis (FEP) participants or controls and to determine whether exposure to different social environments is evident before disorder onset

Endocrine therapy in prostate cancer: time for reappraisal of risks, benefits and cost-effectiveness?

In the 70 years following the first description of the benefits of surgical castration, despite advances in medical therapy e.g. cabazitaxel, enzalutamide, abiraterone, androgen deprivation therapy (ADT) remains the cornerstone of treatment for advanced prostate cancer. However, with increasing numbers of men undergoing PSA testing, the disease is being diagnosed earlier and the costs of ADT, with uncertain survival benefits and associated risks, have risen dramatically. Clinical studies of potent novel agents have shown survival benefits in advanced disease, but timing, risks and cost-effectiveness of treatment remain controversial. As new agents enter clinical practice, a comprehensive research strategy is essential to optimise benefits whilst minimising harm

Association between risk of dementia and very late-onset schizophrenia-like psychosis: a Swedish population-based cohort study

BACKGROUND: Although the incidence of psychotic disorders among older people is substantial, little is known about the association with subsequent dementia. We aimed to examine the rate of dementia diagnosis in individuals with very late-onset schizophrenia-like psychosis (VLOSLP) compared to those without VLOSLP. METHODS: Using Swedish population register data, we established a cohort of 15 409 participants with VLOSLP matched by age and calendar period to 154 090 individuals without VLOSLP. Participants were born between 1920 and 1949 and followed from their date of first International Classification of Diseases [ICD], Revisions 8-10 (ICD-8/9/10) non-affective psychotic disorder diagnosis after age 60 years old (or the same date for matched participants) until the end of follow-up (30th December 2011), emigration, death, or first recorded ICD-8/9/10 dementia diagnosis. RESULTS: We found a substantially higher rate of dementia in individuals with VLOSLP [hazard ratio (HR): 4.22, 95% confidence interval (95% CI) 4.05-4.41]. Median time-to-dementia-diagnosis was 75% shorter in those with VLOSLP (time ratio: 0.25, 95% CI 0.24-0.26). This association was strongest in the first year following VLOSLP diagnosis, and attenuated over time, although dementia rates remained higher in participants with VLOSLP for up to 20 years of follow-up. This association remained after accounting for potential misdiagnosis (2-year washout HR: 2.22, 95% CI 2.10-2.36), ascertainment bias (HR: 2.89, 95% CI 2.75-3.04), and differing mortality patterns between groups (subdistribution HR: 2.89, 95% CI 2.77-3.03). CONCLUSIONS: Our findings demonstrate that individuals with VLOSLP represent a high-risk group for subsequent dementia. This may be due to early prodromal changes for some individuals, highlighting the importance of ongoing symptom monitoring in people with VLOSLP

The incidence of very late-onset psychotic disorders: a systematic review and meta-analysis, 1960–2016

A substantial subset of people with psychotic disorders are first diagnosed in old age, yet little is known about the epidemiology of very late-onset schizophrenia-like psychosis. We investigated the incidence of affective and non-affective psychotic disorders in those aged 65 and above, and examined variation related to potential risk factors via systematic literature review. We searched PubMed, PsychInfo, Web of Science and bibliographies and directly contacted authors to obtain citations published between 1960 and 2016 containing (derivable) incidence data. Cases were those diagnosed with non-organic psychotic disorders after age 65. Findings were presented narratively, and random-effects meta-analyses were used to obtain pooled incidence rates. From 5687 citations, 41 met inclusion criteria. The pooled incidence of: affective psychoses was 30.9 per 100 000 person-years at risk (100 kpy) [95% confidence interval (CI) 11.5–83.4; I 2 = 0.99], and schizophrenia was 7.5 per 100 kpy (95% CI 6.2–9.1; I 2 = 0.99), with some evidence of higher schizophrenia rates in women [odds ratio (OR) = 1.6; 95% CI 1.0–2.5, p = 0.05]. We found narrative evidence of increasing incidence rates of non-affective psychoses with age, and higher rates amongst migrants than baseline populations, but no evidence that incidence varied by study quality or case ascertainment period (quality OR = 1.04; 95% CI 0.74–1.48; time period OR = 1.00; 95% CI 0.95–1.05). Substantial heterogeneity in the incidence of very late-onset schizophrenia-like psychoses was observed. No identified studies examined possible risk factors which may account for such variation, including socio-economic status, sensory impairment, traumatic life events, or social isolation

The impact of supraglacial debris on proglacial runoff and water chemistry

Debris is known to influence the ablation, topography and hydrological systems of glaciers. This paper determines for the first time how these influences impact on bulk water routing and the proglacial runoff signal, using analyses of supraglacial and proglacial water chemistry and proglacial discharge at Miage Glacier, Italian Alps. Debris does influence the supraglacial water chemistry, but the inefficient subglacial system beneath the debris-covered zone also plays a role in increasing the ion contribution to the proglacial stream. Daily hydrographs had a lower amplitude and later discharge peak compared to clean glaciers and fewer diurnal hydrographs were found compared to similar analysis for Haut Glacier d’Arolla. We attribute these observations to the attenuating effect of the debris on ablation, smaller input streams on the debris-covered area, a less efficient subglacial system, and possible leakage into a raised sediment bed beneath the glacier. Strongly diurnal hydrographs are constrained to periods with warmer than average conditions. ‘Average’ weather conditions result in a hydrograph with reverse asymmetry. Conductivity and discharge commonly show anti-clockwise hysteresis, suggesting the more dilute, rapidly-routed melt component from the mid-glacier peaks before the discharge peak, with components from higher up-glacier and the debris-covered areas arriving later at the proglacial stream. The results of this study could lead to a greater understanding of the hydrological structure of other debris-covered glaciers, with findings highlighting the need to include the influence of the debris cover within future models of debris-covered glacier runoff

The Incidence of Nonaffective, Nonorganic Psychotic Disorders in Older People: A Population-based Cohort Study of 3 Million People in Sweden

BACKGROUND: There are limited data on the epidemiology of very late-onset schizophrenia-like psychosis (VLOSLP) and how this relates to potential risk factors including migration, sensory impairment, traumatic life events, and social isolation. METHODS: We followed up a cohort of 3 007 378 people living in Sweden, born 1920-1949, from their 60th birthday (earliest: January 15, 1980) until December 30 2011, emigration, death, or first recorded diagnosis of nonaffective psychosis. We examined VLOSLP incidence by age, sex, region of origin, income, partner or child death, birth period, and sensory impairments. RESULTS: We identified 14 977 cases and an overall incidence of 37.7 per 100 000 person-years at-risk (95% CI = 37.1-38.3), with evidence that rates increased more sharply with age for women (likelihood ratio test: χ2(6) = 31.56, P < .001). After adjustment for confounders, rates of VLOSLP were higher among migrants from Africa (hazard ratio [HR] = 2.0, 95% CI = 1.4-2.7), North America (HR = 1.4, 95% CI = 1.0-1.9, P = .04), Europe (HR = 1.3, 95% CI = 1.2-1.4), Russian-Baltic regions (HR = 1.6, 95% CI = 1.4-1.9), and Finland (HR = 1.6, 95% CI = 1.5-1.7). VLOSLP risk was highest for those in the lowest income quartile (HR = 3.1, 95% CI = 2.9-3.3). Rates were raised in those whose partner died 2 years before cohort exit (HR = 1.1, 95% CI = 1.0-1.3, P = .02) or whose child died in infancy (HR = 1.2, 95% CI = 1.0-1.4, P = .05), those without a partner (HR = 1.9, 95% CI = 1.8-1.9) or children (HR = 2.4, 95% CI = 2.3-2.5), and those whose child had a psychotic disorder (HR = 2.4, 95% CI = 2.2-2.6). INTERPRETATION: We identified a substantial burden of psychosis incidence in old age, with a higher preponderance in women and most migrant groups. Life course exposure to environmental factors including markers of deprivation, isolation, and adversity were associated with VLOSLP risk

Meltwater flow through a rapidly deglaciating glacier and foreland catchment system: Virkisjökull, SE Iceland

Virkisjökull is a rapidly retreating glacier in south-east Iceland. A proglacial lake has formed in the last ten years underlain by buried ice. In this study we estimate water velocities through the glacier, proglacial foreland and proglacial river using tracer tests and continuous meltwater flow measurements. Tracer testing from a glacial moulin to the glacier outlet in September 2013 demonstrated a rapid velocity of 0.58 m s�1. This was comparable to the velocity within the proglacial river, also estimated from tracer testing. A subsequent tracer test from the same glacial moulin under low flow conditions in May 2014 demonstrated a slower velocity of 0.07 m s�1. The glacier outlet river sinks back into the buried ice, and a tracer test from this sink point through the proglacial foreland to the meltwater river beyond the lake indicated a velocity of 0.03 m s�1,suggesting that an ice conduit system within the buried ice is transferring water rapidly beneath the lake. Ground penetrating radar profiles confirm the presence of this buried conduit system. This study provides an example of rapid deglaciation being associated with extensive conduit systems that enable rapid meltwater transfer from glaciers through the proglacial area to meltwater rivers

Urban Birth, Urban Living, and Work Migrancy: Differential Effects on Psychotic Experiences Among Young Chinese Men

BACKGROUND: Urban birth and urban living are associated with increased risk of schizophrenia but less is known about effects on more common psychotic experiences (PEs). China has undergone the most rapid urbanization of any country which may have affected the population-level expression of psychosis. We therefore investigated effects of urbanicity, work migrancy, and residential stability on prevalence and severity of PEs. METHODS: Population-based, 2-wave household survey of psychiatric morbidity and health-related behavior among 4132 men, 18-34 years of age living in urban and rural Greater Chengdu, Sichuan Province, China. PEs were measured using the Psychosis Screening Questionnaire. RESULTS: 1261 (31%) of young men experienced at least 1 PE. Lower levels of PEs were not associated with urbanicity, work migrancy or residential stability. Urban birth was associated with reporting 3 or more PEs (OR: 1.63; 95% CI: 1.25-2.11), after multivariable adjustment, with further evidence (P = .01) this effect was restricted to those currently living in urban environments (OR: 1.78; 95% CI: 1.16-2.72). Men experiencing a maximum of 5 PEs were over 8 times more likely to have been born in an urban area (adjusted odds ratio [AOR] 8.81; 95% CI 1.50-51.79). CONCLUSIONS: Men in Chengdu, China, experience a high prevalence of PEs. This may be explained by rapid urbanization and residential instability. Urban birth was specifically associated with high, but not lower, severity levels of PEs, particularly amongst those currently living in urban environments. This suggests that early and sustained environmental exposures may be associated with more severe phenotypes